Which is better a mixed insulin or bolus and background

Basal and bolus gives you a lot more flexibility with when and what you eat.
I use a pump now but used lantus and novorapid for 9 years and found it a lot better than when I previously used various mixed insulins. I remember clinic appointments where I would tell them I didn't want to eat breakfast, and being told in no uncertain terms, I had to eat breakfast, it wasn't an option to not have it. With basal and bolus you can have a massive breakfast or no breakfast or anything in between!

Hi there, I've never been on a mixed and am on novarapid and Lantus (my Consultant says that works for the select few in certain circumstances but a bolus & background is far more flexible and suited to the modern world), and I can only say it is a perfect combination for me, once I got the background sorted it meant that I could eat whenever I wanted (I work shifts) or even miss a meal altogether or fast for 24 hours (not necessarily on purpose but due to work) and so on. I feel you are in far more control on this regime. x

Pigletlapland said:

Hi I was diagnosed type 1 two months ago after being told I was type 2 last Feb. At the moment I am on Humalog mix 25 but my DN is suggesting going on to a more flexible type with a separate background insulin. What are people's thoughts and experiences please

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Hello I started off on humalog mix 25 and like Kim has said found it very frustrating that it was fixed and had no room for correction. It actually wasn’t really helpful at all for me personally because I don’t have a fixed routine as such and like to do things on a whim. I changed to humalog and abasaglar a few months later and have found this much better and has improved my levels as well

I started with basal and bolus, and wouldn't want it any different. My life and eating habits are very varied from day to day, I think it would be impossible to manage that with mixed insulin.
@urbanracer , weren't you on mix for a long time by preference or am I mixing up people?

Antje77 said:

I started with basal and bolus, and wouldn't want it any different. My life and eating habits are very varied from day to day, I think it would be impossible to manage that with mixed insulin.
@urbanracer , weren't you on mix for a long time by preference or am I mixing up people?

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Yes @ANTJE, lunchtime especially is a right royal pain because your mixed dose from the morning has already run out and you won't be injecting again until the evening. I got by, but much happier on MDI.

I absolutely disliked mixed insulin, I was prescribed mixtard 30 back in 2001. I had several hospital trips from 2001-2004/5 due to DKA. I was running consistently high for a long period of time, I remembered going to diabetes children groups and nurses there had to inject either actrapid or novorapid to bring my levels down. It was so inflexible that I had to force myself to eat carbs when I was full and lunch time dose would run out until dinner time so I was high for a long time. It was also during the time of where I was growing with hormones etc and it didn’t help with my levels, so all in all, it was a mess. I prefer basal and bolus regime, you can correct high levels, you can bolus for food whenever and wherever you are, you can fast or skip meals, you can adjust to whatever food item is in front of you without forcing yourself to eat. It is definitely the bees knees and less hospital trips. I did wish they introduced it to me sooner rather than after my several DKA trips.

Multiple injections is much better suited to the worlds level of knowledge when it comes to diabetes management....

I felt that the mixed insulin was suited to a time where there was less knowledge and understanding overall....

Basal/bolus is much better. It allows flexibility in what and when you can eat. Mixed insulns you have to eat a certain amount at a certain time

There is no contest. Basal/Bolus (aka MDI) is the best approach and what NICE recommends for T1. Mixed is best reserved for those who have a fear of injections or just can't cope with 4/5 instead of 2.

@Pigletlapland . Basal/ Bolus is definitely a better option than pre mixed .
I’ve experienced both and would never consider returning to a mixed insulin regime.
Basal/ Bolus enables you to mimic what your pancreas was actually doing prior to deciding to go awol.